M Guibert1, B Lepage, V Woisard, M Rives, E Serrano, S Vergez. 1. Service d'ORL et chirurgie cervicofaciale, CHU de Toulouse, hôpital Rangueil-Larrey, 24, chemin de Pouvourville, 31059 Toulouse cedex 9, France.
Abstract
OBJECTIVE: To study quality of life in patients treated for advanced hypopharyngeal or laryngeal cancer, with laryngeal conservation or laryngectomy. PATIENTS AND METHODS: A retrospective 2-center study included 100 patients in remission from squamous cell carcinoma, treated between 1998 and 2009. Seventy patients (24 hypopharynx, 46 larynx) were treated by total (pharyngo-) laryngectomy followed by external radiation therapy, and 30 (13 hypopharynx, 17 larynx) underwent an organ-conservation protocol with concurrent radiochemotherapy or with induction chemotherapy using platin-5FU or taxan-platin-5FU followed by radiation therapy. All patients responded to the quality of life questionnaires (EORTC QLQ-C30 and QLQ-H&N35). RESULTS: Advanced tumor stages IVa and IVb were significantly more frequent in the surgery groups (hypopharynx: 71.6% vs. 45.9%, p=0.01; larynx: 72.4% vs. 37.5%, p<0.01). In pharyngeal cancer, the only significant difference between surgical treatment and laryngeal conservation was for "sensory disorder" (taste and odor), with better results in case of laryngeal conservation (p<0.0001). For the other items, there was a trend for quality of life to appear better in patients with laryngeal conservation (p=NS). In laryngeal cancer, the only significant difference was for "dry mouth", which was significantly less invalidating with surgical treatment (p<0.001). The impairment of the other quality of life items did not differ between surgical and conservative treatment. CONCLUSIONS: Quality of life is impaired in all patients treated for pharyngeal or laryngeal cancer. The type of treatment, surgical or conservative, affects differently various aspects of quality of life. Copyright Â
OBJECTIVE: To study quality of life in patients treated for advanced hypopharyngeal or laryngeal cancer, with laryngeal conservation or laryngectomy. PATIENTS AND METHODS: A retrospective 2-center study included 100 patients in remission from squamous cell carcinoma, treated between 1998 and 2009. Seventy patients (24 hypopharynx, 46 larynx) were treated by total (pharyngo-) laryngectomy followed by external radiation therapy, and 30 (13 hypopharynx, 17 larynx) underwent an organ-conservation protocol with concurrent radiochemotherapy or with induction chemotherapy using platin-5FU or taxan-platin-5FU followed by radiation therapy. All patients responded to the quality of life questionnaires (EORTC QLQ-C30 and QLQ-H&N35). RESULTS: Advanced tumor stages IVa and IVb were significantly more frequent in the surgery groups (hypopharynx: 71.6% vs. 45.9%, p=0.01; larynx: 72.4% vs. 37.5%, p<0.01). In pharyngeal cancer, the only significant difference between surgical treatment and laryngeal conservation was for "sensory disorder" (taste and odor), with better results in case of laryngeal conservation (p<0.0001). For the other items, there was a trend for quality of life to appear better in patients with laryngeal conservation (p=NS). In laryngeal cancer, the only significant difference was for "dry mouth", which was significantly less invalidating with surgical treatment (p<0.001). The impairment of the other quality of life items did not differ between surgical and conservative treatment. CONCLUSIONS: Quality of life is impaired in all patients treated for pharyngeal or laryngeal cancer. The type of treatment, surgical or conservative, affects differently various aspects of quality of life. Copyright Â
Authors: F G R Souza; I C Santos; A Bergmann; L C S Thuler; A S Freitas; E Q Freitas; F L Dias Journal: Health Qual Life Outcomes Date: 2020-04-03 Impact factor: 3.186